Having suffered from chronic leg ulcers for over five years, here is my two penny worth, the standard advice is NOT suitable for everyone. I can also back this up not only with my own experience but that of my Ex-Wife who works as a Nurse Carer in the Community and has treated hundreds of elderly people with the same problem.
She often mentions how some of her patients are in tears having their wounds tended to, dressed, how compression systems eg Coban mean they are in constant pain with little relief. She had joked to one of her patients, who kept putting her knitting needles inside her compression dressings as the itching was so intense that she would infect her wounds and risk amputation. Words said in jest at the time, but several months later she visited the lady and was greeted by her elderly daughter. She went in to see her former charge and said "Hello Flo how are you ?" and Flo's daughter said " well Mum is finding it hard after the amputation." True story.
I can relate to the miserable pain and suffering, waking in the night to find the bedding has stuck to your legs where blood has seeped through etc etc.
If I wear shoes or socks my legs and feet heat up and start to create new wounds, If I wear long trousers again either my legs stick to the fabric, or the change in atmosphere creates new wounds. Anything you can get to heal risks reverting to an ulcer in minutes, even trying to show or take a bath can cause me to open new wounds.
Now I might be an odd chap or unique but, the standard advice from Doctors, District Nurses, Wound Specialists from the Compex Leg Ulcer Service is that moisturising the skin is of paramount importance. After all otherwise your skin will crack and open and get infected, in my case my skin has opened and cracked and gotten infected precisely zero times.
What does cause all my wounds, each and everyone of them is using the damned cream in the first place, I must have said a hundred times to Health Professionals "if I use the cream and make my skin soft I start to leek through everywhere and my legs become macerated which leads to all these areas becoming infected and then ulcerate". I have had a hundred replies now each and every one of them ignoring that feedback and saying "you must use the cream". My children who have seen the evidence first hand and who accompany me due to another disability are incredulous at how my feedback is ignored.
After five years now of extensive trial and error, I know what works best and what certainly does not, I cannot use any dressing that has adhesive surrounds as that will open new wounds, using tape to hold a dressing cannot come into contact with my skin or new wound, and on and on.
Last Friday a saw a practice nurse who put on some dressings, she particularly is terrible and never listens to feedback, we are like oil and water. I saw her about a year ago as I had bad infections and ulcerations in my left foot, I had seen the Doc the night before who wanted some swabs taken. Early next morning and went in to have Swabs taken, its her, my heart sinks, here we go again, "I have come in to have some Swabs taken" so lay down on the couch, my son removes my shoe and sock, she glances over from the computer " You dont need them done, it has healed". Clearly someone who has zero knowledge about these issues, I try to explain "it may look healed but that scab will go to mush in an hour", "Oh no it wont it has healed, do you know how much experience I have, I know more about it than you". Giving up I said " actually I dont want them done, it was the Doctor who said I needed them but you must have more experience than him" walked out stealing the two swab sets on the side, went home, my son swabbed the infected areas, half an hour later dropped off at the Doctors, next morning Metronidazole & Erythromycin delivered by the pharmacist
Sorry for waffling but when I got home on Friday, I corrected her dressings and saw her again this monday morning, I had managed to see a little improvement so was explaining what had worked. "Your legs are very dry" she said, "I know that is what is helping them heal" says I. "We need to put some cream on them to stop them cracking" she said, "That isnt the problem if we use cream they will macerate very quickly and get worse" said I. "Yes we need to put some cream on them" giving up I didnt say anything, so she creamed my legs, used a foam dressing pad with external adhesive that makes instant wounds as the foam just sucks more fluid opening the wound even more ( told her they are unsuitable God knows how many times ). By the time I got home they were getting worse, took the foam pad off the main wound, by last night six or seven more ulcers have opened up.
Perhaps I should write a book but treatment should be patient specific not blind proforma dogma, the best Nurse I have had was about 65, old school from Matron's Days. exceptional care, beautifully applied full toe to knee dressings that actually even felt comfortable. Oh for the days when Nursing was a vocation with inspired dedicated ladies.